Key result
Peridevice leak following LAmbre-assisted left atrial appendage closure occurred in 15.7% of patients at 12 months and was not associated with an increased risk for thromboembolic events.
Why the study?
The incidence, risk factors, and clinical impact of peridevice leaks following left atrial appendage closure with the LAmbre device were unknown.
Does peridevice leak following left atrial appendage closure with the LAmbre device increase the risk of thromboembolic events in patients with atrial fibrillation?
Cohort (n=152)
Yes
Does peridevice leak following left atrial appendage closure with the LAmbre device increase the risk of thromboembolic events in patients with atrial fibrillation?
Peridevice leak after LAmbre LAAC occurs in about 15% of patients at 1 year, is related to larger anatomy and device size, but does not appear to increase thromboembolic risk.
Does not justify altering post-LAmbre anticoagulation for leaks; leaves open need for prospective confirmation.
BACKGROUND: In the present study, we sought to explore the incidence, risk factors, and clinical impact of peridevice leaks (PDLs), following LAmbre-assisted left atrial appendage closure (LAAC). METHODS: We performed transesophageal echocardiography (TEE) on patients participating in the LAmbre multicenter study, at Day 1 postimplantation, then at 3 and 12 months to assess PDL, device-related thrombus, left atrial appendage (LAA) thrombus, and left atrial thrombus. Clinical events were recorded during follow-up. RESULT: A total of 152 patients with atrial fibrillation successfully completed LAAC. At 3 months follow-up, 123 patients underwent TEE, with 21 (17%) of them presenting PDL. Among the 121 patients who underwent TEE at 12 months follow-up, 19 (15.7%) presented PDL. Patients with PDL exhibited larger LAA orifice diameters and larger device sizes compared to those in the no leak group. In addition, we found no significant differences in thromboembolic events between patients in the PDL and no leak groups. CONCLUSION: LAmbre-assisted LAA closure resulted in a relatively low PDL occurrence, and its rate decreased over time. In addition, PDL was more prominent in patients with larger LAA orifice diameter and larger device size. However, the condition was not associated with an increased risk for thromboembolic events.
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Wang et al. (2020) conducted a cohort in Atrial fibrillation (n=152). Peridevice leak (PDL) vs. No peridevice leak was evaluated on Peridevice leak at 12 months. Peridevice leak following LAmbre-assisted left atrial appendage closure occurred in 15.7% of patients at 12 months and was not associated with an increased risk for thromboembolic events.
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